Abstract
AIDS patients with newly diagnosed cytomegalovirus (CMV) retinitis who had just completed a 14-day course of ganciclovir induction therapy were randomly assigned to an alternating or concurrent combination regimen of chronic ganciclovir-foscarnet therapy for CMV retinitis. Each regimen used lower weekly cumulative doses of each drug than standard monotherapy maintenance treatment regimens. Dose-limiting toxicity attributable to foscarnet occurred in only 2 (7%) of 29 evaluatable patients, and no patients experienced dose-limiting nephrotoxicity. Although absolute neutrophil counts <500 cells/μL occurred in 11 (38%) of 29 patients, all who subsequently used adjunctive granulocyte colony-stimulating factor had severe neutropenia prevented. Severe toxicity of any type and neutropenia, in particular, occurred significantly more frequently in patients assigned to the concurrent treatment regimen. CMV was isolated from none of 21 patients who had urine cultured and from only 1 of 24 who had blood cultured while being treated during the study (median evaluation, 12 weeks). This suggests that combination therapy provides better in vivo antiviral activity in suppressing CMV replication than previously reported with monotherapy regimens.
| Original language | English |
|---|---|
| Pages (from-to) | 189-193 |
| Number of pages | 5 |
| Journal | Journal of Infectious Diseases |
| Volume | 170 |
| Issue number | 1 |
| State | Published - Jul 1 1994 |
| Externally published | Yes |
Fingerprint
ASJC Scopus subject areas
- Immunology
- Public Health, Environmental and Occupational Health
Cite this
Randomized Phase I Trial of Two Different Combination Foscarnet and Ganciclovir Chronic Maintenance Therapy Regimens for AIDS Patients with Cytomegalovirus Retinitis : AIDS Clinical Trials Group Protocol 151. / Jacobson, Mark A.; Kramer, Francoise; Bassiakos, Yiannis; Hooton, Thomas; Polsky, Bruce; Geheb, Heidi; O'Donnell, James J.; Walker, John D.; Korvick, Joyce A.; Van Der Horst, Charles.
In: Journal of Infectious Diseases, Vol. 170, No. 1, 01.07.1994, p. 189-193.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Randomized Phase I Trial of Two Different Combination Foscarnet and Ganciclovir Chronic Maintenance Therapy Regimens for AIDS Patients with Cytomegalovirus Retinitis
T2 - AIDS Clinical Trials Group Protocol 151
AU - Jacobson, Mark A.
AU - Kramer, Francoise
AU - Bassiakos, Yiannis
AU - Hooton, Thomas
AU - Polsky, Bruce
AU - Geheb, Heidi
AU - O'Donnell, James J.
AU - Walker, John D.
AU - Korvick, Joyce A.
AU - Van Der Horst, Charles
PY - 1994/7/1
Y1 - 1994/7/1
N2 - AIDS patients with newly diagnosed cytomegalovirus (CMV) retinitis who had just completed a 14-day course of ganciclovir induction therapy were randomly assigned to an alternating or concurrent combination regimen of chronic ganciclovir-foscarnet therapy for CMV retinitis. Each regimen used lower weekly cumulative doses of each drug than standard monotherapy maintenance treatment regimens. Dose-limiting toxicity attributable to foscarnet occurred in only 2 (7%) of 29 evaluatable patients, and no patients experienced dose-limiting nephrotoxicity. Although absolute neutrophil counts <500 cells/μL occurred in 11 (38%) of 29 patients, all who subsequently used adjunctive granulocyte colony-stimulating factor had severe neutropenia prevented. Severe toxicity of any type and neutropenia, in particular, occurred significantly more frequently in patients assigned to the concurrent treatment regimen. CMV was isolated from none of 21 patients who had urine cultured and from only 1 of 24 who had blood cultured while being treated during the study (median evaluation, 12 weeks). This suggests that combination therapy provides better in vivo antiviral activity in suppressing CMV replication than previously reported with monotherapy regimens.
AB - AIDS patients with newly diagnosed cytomegalovirus (CMV) retinitis who had just completed a 14-day course of ganciclovir induction therapy were randomly assigned to an alternating or concurrent combination regimen of chronic ganciclovir-foscarnet therapy for CMV retinitis. Each regimen used lower weekly cumulative doses of each drug than standard monotherapy maintenance treatment regimens. Dose-limiting toxicity attributable to foscarnet occurred in only 2 (7%) of 29 evaluatable patients, and no patients experienced dose-limiting nephrotoxicity. Although absolute neutrophil counts <500 cells/μL occurred in 11 (38%) of 29 patients, all who subsequently used adjunctive granulocyte colony-stimulating factor had severe neutropenia prevented. Severe toxicity of any type and neutropenia, in particular, occurred significantly more frequently in patients assigned to the concurrent treatment regimen. CMV was isolated from none of 21 patients who had urine cultured and from only 1 of 24 who had blood cultured while being treated during the study (median evaluation, 12 weeks). This suggests that combination therapy provides better in vivo antiviral activity in suppressing CMV replication than previously reported with monotherapy regimens.
UR - http://www.scopus.com/inward/record.url?scp=0028364090&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028364090&partnerID=8YFLogxK
M3 - Article
C2 - 8014496
AN - SCOPUS:0028364090
VL - 170
SP - 189
EP - 193
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
SN - 0022-1899
IS - 1
ER -